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Sebelius Explains White House’s Contraception Compromise

February 10, 2012 at 12:00 AM EDT
In an abrupt shift in policy Friday, President Obama backtracked some, announcing that religious employers would not be required to offer free birth control to employees after all. Instead the burden would be on insurers. Ray Suarez and Secretary of Health and Human Services Kathleen Sebelius discuss the president's new plan.
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JEFFREY BROWN: President Obama backtracked some today on a birth control insurance mandate. His new plan sought to satisfy critics of the plan, while maintaining support from women’s health advocates.

The president entered the White House Briefing Room bent on calming a political storm.

PRESIDENT BARACK OBAMA: Religious liberty will be protected, and a law that requires free preventive care will not discriminate against women.

JEFFREY BROWN: Just three weeks ago, the administration announced that religiously affiliated schools, hospitals and other institutions had to cover birth control free of cost. Roman Catholic officials, in particular, charged the mandate would force them to violate their own teachings.

Today, the president said the revised plan would address that objection.

BARACK OBAMA: Under the rule women will still have access to free, preventive care that includes contraceptive services no matter where they work. So that core principle remains.

But if a woman’s employer is a charity or a hospital that has a religious objection to providing contraceptive services as part of their health plan, the insurance company — not the hospital, not the charity — will be required to reach out and offer the woman contraceptive care free of charge without co-pays and without hassles.

JEFFREY BROWN: The president of the Catholic Health Association, representing Catholic hospitals, welcomed the decision.

Sister Carol Keehan said in a statement, “The framework developed has responded to the issues we identified that needed to be fixed.”

The head of the U.S. Conference of Catholic Bishops was more restrained. Archbishop of New York Timothy Dolan said, “Today’s decision to revise how individuals obtain services that are morally objectionable to religious entities and people of faith is a first step in the right direction.”

Groups that supported the birth control mandate, from Planned Parenthood to the National Organization for Women, backed the compromise.

Louise Melling is deputy legal director for the American Civil Liberties Union.

LOUISE MELLING, American Civil Liberties Union: We were pleased that, today, the Obama administration made perfectly clear its longstanding commitment to contraceptive coverage, that it made clear, again, and reaffirmed its commitment to ensure that women across the country, no matter where they work, will be able to have coverage for contraception.

JEFFREY BROWN: For their part, Republican presidential candidates kept up their criticism of the original mandate.

Former House Speaker Newt Gingrich spoke at a gathering of conservative activists in Washington.

NEWT GINGRICH (R): Our core document says we are endowed by our creator with certain unalienable rights. And Barack Obama seeks to cut across those.

And I, frankly, don’t care what deal he tries to cut, this is a man who is deeply committed — if he wins reelection, he will wage war on the Catholic Church the morning after he’s reelected. We cannot trust him, we should — we know who he really is, and we should make sure the country knows who he really is.

(APPLAUSE)

JEFFREY BROWN: At that same conference, former Pennsylvania Sen. Rick Santorum accused the administration of overreach. He spoke shortly before the president’s remarks.

RICK SANTORUM (R): This is the kind of coercion that we can expect. It’s not about contraception. It’s about economic liberty. It’s about freedom of speech. It’s about freedom of religion. It’s about government control of your lives. And it’s got to stop.

(CHEERING AND APPLAUSE)

JEFFREY BROWN: Mitt Romney didn’t directly respond to the Obama announcement, but he vowed that his would be a pro-life presidency.

MITT ROMNEY (R): And I will reverse every single Obama regulation that attacks our religious liberty and threatens innocent life in this country.

JEFFREY BROWN: The president today suggested the political uproar should die down now that the policy has changed.

BARACK OBAMA: I understand some folks in Washington may want to treat this as another political wedge issue, but it shouldn’t be. I certainly never saw it that way.

This is an issue where people of good will on both sides of the debate have been sorting through some very complicated questions to find a solution that works for everyone. With today’s announcement, we’ve done that.

JEFFREY BROWN: With the president hoping to put the birth control furor behind him, aides will be watching to see if Republicans in Congress push ahead with emergency legislation on the issue.

RAY SUAREZ: This afternoon, I spoke about the president’s decision with Kathleen Sebelius, the secretary of health and human services. She spoke from the front lawn of the White House, where construction has been under way for more than a year, work that resumed during our interview.

Secretary Sebelius, welcome back to the NewsHour.

HEALTH AND HUMAN SERVICES SECRETARY KATHLEEN SEBELIUS: Thank you. Nice to be with you, Ray.

RAY SUAREZ: Could the administration have avoided a damaging fight over contraception coverage by announcing this policy in the first place?

KATHLEEN SEBELIUS: Well, I think what people missed is that the announcement that I made two weeks ago suggested that we were moving ahead with the exemption that had been originally drafted, but, also, we would spend time reaching out to stakeholders, to religious employers who objected to offering this coverage, and we would spend a year finding arrangements that both respected their religious liberty, but made sure at the end of the day that women employees of these institutions, whether she was a university professor or a nurse or a janitor, could make their own determination about very important preventive health care.

RAY SUAREZ: Did you have any idea what was coming? Were you warned by administration colleagues about possible backlash?

KATHLEEN SEBELIUS: Well, there were certainly people who felt we should broaden the exemption greatly.

I think the president from the outset determined that he was not willing to have millions of American women bear the financial burden of their employer deciding they should not access contraception, a drug that is the most frequently used prescription drug of women 14 to 40, and that often has a serious financial cost, up to $600 if a woman is paying out of pocket for it.

So, on one hand, we wanted to make sure that the preventive health benefits, no co-pays, no co-insurance applied to the whole range of IOM recommendations, so keep the exemption narrow, for churches and church affiliates, but also use the time to look at the 28 states which have mandatory contraceptive coverage, see what arrangements were satisfactory to the various Catholic institutions who right now offer that coverage, universities and hospitals, and deem that to be effective going forward.

When the firestorm broke out, the president basically said, we have got to speed up this process. Let’s find a solution respecting religious liberty and guaranteeing that millions of women in America, and really all women in America now, have insurance policies that will have a range of health services needed by them and their families without co-pays and co-insurance to make sure they can access them.

RAY SUAREZ: So, you mentioned the administration spoke to religious institutions beforehand. Have you spoken to them about this latest adjustment, this latest change of policy?

It’s reported that President Obama has already spoken to Archbishop Timothy Dolan of New York, one of the senior leaders of the Catholic Church.

KATHLEEN SEBELIUS: Well, I don’t — I know he has reached out to Archbishop Dolan. I know he has spoken to Sister Carol Keehan from the Catholic Health Association, who has issued a statement very supportive of this rule that we’re going to publish in the federal register today.

I know he has spoken to Cecile Richards from Planned Parenthood, who was also very supportive of the rules we put out today. We are going to be — again, as we develop the specifics around this regulation, work with insurance companies, work with institutions.

But I think this does exactly what the president asked us to do, which is make sure that millions of women, regardless of who their employer is, can make their own health decisions, have access to this full range of very important preventive health services, as recommended by the Institute of Medicine, and at the same time respect the religious liberty of their employers who may object to either paying for or directly offering this coverage.

RAY SUAREZ: Secretary, can we talk about mechanics? If you’ve just taken a new job at a religiously based hospital or university, your employee paperwork is silent on reproductive health care, what happens next?

KATHLEEN SEBELIUS: Well, typically, if you are a new employee and in an insured plan, the insurance company or the variety of insurance companies are the ones who actually publish the benefit package.

So, in this case, again, the insurance company would be reaching out to employees, making it clear that it is their choice whether to access contraceptive benefits. And what we know, Ray, is that actually this is a no-cost benefit, that the National Business Council on Health, that our actuaries, a variety of people in group plans say having contraception as part of a group insurance plan actually lowers the overall cost, doesn’t increase it, because, on balance, preventive services around family planning, avoiding what may be unhealthy pregnancies, avoiding the health consequences of that actually is a cost reducer.

So we have a situation where the insurance companies directly offer this benefit to the women employees, and the religious employer doesn’t pay for it, doesn’t refer to it, and doesn’t have to offer it.

RAY SUAREZ: You say money from the religious institutions doesn’t pay for this, but isn’t money fungible?

If a Catholic nonprofit is paying for your insurance coverage, isn’t it paying for contraception if you are getting the coverage through that same insurer?

KATHLEEN SEBELIUS: Well, again, Ray, in this case, actuaries have looked at this benefit.

The federal employees health plan, when contraception was added to federal employees’ benefit, which is the largest employee group in the country, costed this as no cost, free, no cost, because adding contraception and having some employees take advantage of that coverage lowers the overall cost of the health plan.

So we have that in place around the country. We have actuaries that have inserted that, and so we’re not — this isn’t a shell game of passing the costs along. This is a real no-cost option that is, according to the National Business Council on Health, could reduce an insurance plan by about 15 percent. We’re not counting on that.

But I think we can say very safely that this doesn’t add to the cost of either the employer’s plan — and we know that women, if they have to purchase this coverage outside of a health plan, could spend up to $600, which is a substantial financial barrier to access a very important health benefit and a benefit used by 99 percent of women across this country at some point in their lives.

RAY SUAREZ: Well, you’ve transferred the administrative burden to insurance companies. Are insurers ready to pay? Have they signed on?

KATHLEEN SEBELIUS: We will be doing just that.

But as part of the Affordable Care Act, our department will define the rules under which we offer these benefits. And we’re confident that this works and that insurers are prepared to step up and do this. Again, this is in place in many states in the country right now, where there is an insurance company providing benefits to employees, and the employer not directly offering those benefits.

RAY SUAREZ: Health and Human Services Secretary Kathleen Sebelius, Madam Secretary, thanks for joining us.

KATHLEEN SEBELIUS: Great to be with you, Ray.